Ways to Resolve the Medical StalemateThe key cause of the protracted medical impasse is the nation＇s medical insurance system, which does not even compensate the doctors for the basic cost of treatment. The current medical insurance system, hurriedly put together by several scholars and bureaucrats during the past military dictatorship, had at least one merit. It offered the majority of people easy access to cheap medical treatment by rapidly expanding to cover the entire population in just 12 years. Nevertheless, it is an irrational system that does not compensate even the basic costs of adequate care. In view of this, the government gave tacit consent to the doctors to recover the losses incurred by treating insured patients by ＂whatever measures they deemed fit.＂ Doctors in turn resorted to ingeniously irregular measures to increase their profits, ranging from excessive treatment to overcharging patients.
Increasing revenues by dispensing medicine is only one of the irregular measures. The policy of forcibly keeping medical fees low for essential treatments caused doctors to neglect their duties to treat the sick. If the situation is left as it is, there is no doubt that this phenomenon will become more widespread.
This is why it is such an urgent task to fundamentally reform the health care system. The problem is that both bureaucrats and the doctors are failing to accurately perceive the essence of the problem, because the irregular management has persisted for several decades.
A pediatrician who runs his own clinic even confessed, ＂Before the government＇s recent attempt at reform, there were doctors with private clinics not even aware that about 60 percent of their revenues came from dispensing medicine.＂ If practicing doctors did not know this, then it goes without saying that the policymakers had even less of a clue. The policymakers reportedly assumed that the proportion of revenues from dispensing medicine at private clinics would be around 30 percent, the same level as at general hospitals.
The new medical reform, aimed at separating the overlapping roles of doctors and pharmacists, was enforced though critically disabled by a lack of understanding of all the relevant facts, and sparked fierce resistance from doctors. The government went on to respond in a manner that drove the doctors into a drawn-out dispute.
A case in point is the arrest of the chairman of the Korean Medical Association, a person who is unlikely to go into hiding. His arrest effectively served to block the channel of dialogue with the medical community. It is inevitable that compromise will prove elusive in the absence of dialogue, which in turn causes protests to intensify. In the process, the real power of the protest movement shifted from the elderly practitioners, who at least have a general understanding of the reality, to the young specialists, who have clung stubbornly to rigid principles.
The government＇s measures to cope with the specialists＇ strikes were also hopeless beyond words. For instance, it threatened the striking doctors with military conscription - a highly impractical, if not totally fanciful, measure. It fanned the anger and has simply aggravated the current situation.
The current gridlock can never be resolved through makeshift and stopgap measures.
Medical insurance coverage is a basic right every citizen should be able to enjoy. It is an important institution that cannot rely solely on the doctors＇ sense of duty. For its success, the government has to take practical measures to improve the overall health care system so that everyone can receive quality medical services.
The government should guarantee a basic medical service for all, and allow doctors to charge more for those who desire - and can afford - a higher quality service. In this way, the overall quality of medical service would improve, and the profits could be used to upgrade medical services for the general public.
Medical practice is a service. If a service is to improve, there must be investment and competition. Instead of unilaterally lowering the quality of medical service to a mediocre standard for the entire population, the government should encourage investment and competition so that deserving doctors prosper. Only then can the people have trust in the medical system.
Both the government and the medical community must accept and admit that they are both sinners before the people and engage in dialogue to come up with a reliable blueprint for medical reforms.
by Hwang Se-hee